Individual
JACOB GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2421 W. 21ST STREET, CLOVIS, NM 88101
(505) 763-9800
(505) 769-1998
Mailing address
2421 W. 21ST STREET, CLOVIS, NM 88101
(505) 763-9800
(505) 769-1998
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
92-226
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F2661
—
NM
01
—
P00344928
RAILROAD MEDICARE PIN
NM
Enumeration date
05/11/2006
Last updated
10/07/2009
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